Riverbark Veterinary Hospital treats you and your pets like members of our family, caring for their health and wellbeing with true compassion.

Nobody likes to think about surgery. Though should your pet need it, you can trust Riverbark to provide the latest and greatest technology and procedures. Our surgical services include thorough screenings and consultations with board-certified veterinary surgeons for the latest procedures available.

We offer advanced soft tissue procedures such as laparoscopy, thoracoscopy, surgical stapling and orthopedic and reconstructive surgery, along with routine procedures such as spay and neuter surgeries.

Because every animal is unique, Riverbark centers our wellness, behavioral and nutritional care around your pet's lifestyle and specific needs.

In addition to comprehensive physical examinations, our pet health services include parasite testing and prevention, immunizations, life-stage blood testing and diagnostics or monitoring related to your pet's individualized care. We encourage all owners to participate in their pet's wellness planning.

Just because they're covered with fur doesn't mean they can't have skin problems. But they may be harder to diagnose. We'll work closely with you to find the source of discomfort and create a plan to alleviate the problem.

We all get tired, sore and creaky as we get older—or suffer sprains, strains, twists, and other muscle or joint injuries. That includes pets, too.

Sometimes your pet’s illness or distress can’t be seen on the outside. That’s where Internal Medicine can be helpful. This specialty includes the diagnosis and treatment of diseases of the respiratory, gastrointestinal, hepatic (liver), pancreatic, renal (kidney), uro-genital, endocrine, cardiac, neurologic, and hematologic (blood) systems.

At Riverbark, we care for your pet as if he or she were our own. We maintain the highest standards of care based on guidelines set by the AAHA accreditation process, so you can be assured your pet will receive the best possible veterinary care.

Our patient-family-centered approach to treatment individualizes the care plan based on the type of animal, breed, age, health concerns, and your family's lifestyle. We care for almost every kind of pet - dogs, cats, reptiles, birds and pocket pets.

We follow up with recommendations and advice to help you make informed decisions moving forward. To this end, our website also offers educational information, links, and resources on important topics to all pet owners.

Riverbark hosts a series of monthly workshops in the Educational Room at our Manchester location covering topics, such as:

Hip Dysplasia

Heartworm Disease

Allergies (Environmental, Food, Parasite)

Periodontal Disease

ACL Injuries in Canines

Advances in Surgery for Pets

Physical Rehabilitation and Rehabilitation Medicine

Hyperthyroidism in Cats

Diabetes in Dogs and Cats

Ear Diseases—Why and How to Prevent

We invite owners to join us for an informative discussion of these and other issues. Light refreshments and drinks will be served.

Physical rehabilitation techniques at Riverbark are beneficial for a variety of pets, including those recovering from surgery, canine athletes, hyperactive or overweight pets, and older pets suffering from mobility problems, arthritis, neurological disease, athletic injury, or those pets needing to maintain and/or build conditioning muscles.

We offer the latest equipment, techniques and procedures to help your companion feel his or her best and perform at the highest capability. And many of our post-surgical physical rehabilitation procedures may actually help prevent surgery. We'll also create an individualized treatment plan for your pet.

Physical rehabilitation can help conditions, like hip dysplasia, by building strength in the hip area. Regular pet massage can also aid by increasing flexibility and possibly reducing pain and avoiding surgery. In older dogs suffering from conditions such as arthritis, disc pain and joint problems, regular physical rehabilitation can help increase strength and flexibility and reduce pain. We offer these services at our Pet Retreat.

Maintaining the dental and oral health of your pets is extremely important. Riverbark provides diagnosis and treatment plans for diseases of the teeth, oral cavity and maxillofacial area, and dental and oral surgery as needed.

Your pets give you their whole heart, but they can't tell you when something's wrong with it. That's why we offer advanced diagnostic technology and consultation with a board-certified veterinary cardiologist, with the aim of helping your pet live longer and enjoy a higher quality of life.

We can diagnose and treat a variety of heart-related issues, including mitral and tricuspid valve disease, hypertrophic cardiomyopathy, dilated cardiomyopathy and pericardial effusions.

Just like us humans, eyesight issues and eye disease can "sneak up" on pets, too. We often see cataracts, glaucoma, corneal ulceration, eyelid defects and tumors. At Riverbark, our ophthalmology professionals focus on treating these diseases and other conditions that affect your pet's eyes. For cataracts, glaucoma and a few other issues, we refer to a board-certified ophthalmologist for further treatment and surgery.

Our ophthalmology diagnostics include:

Applanation tonometry

Fluoroscein staining

Nasolacrimal flushing

Schirmer tear test

Indirect and direct retinal examination

External ocular photography and fundus photography

Hyperthyroidism is a disorder caused by excess thyroid hormone in the bloodstream and body. It is the most common hormonal disorder in domestic cats. The same treatment options that exist in humans exists in cats.

These treatment options include:

1. Medication to suppress the thyroid hormone

2. Surgical removal of the thyroid tumor

3. Feeding a life-long low-iodine commercial diet

4. Radioactive Iodine (Radioiodine I-131) therapy to destroy the thyroid tumor. Radioiodine I-131 is the treatment of choice because it is effective and a safe cure regardless of your cat’s age. If left untreated, however, hyperthyroidism can be fatal.

Q1. What is Hyperthyroidism?

Hyperthyroidism is an excessive amount of circulating thyroid hormone in the bloodstream. It is seen in middle-aged to geriatric cats. It is caused by one or more benign tumors of the thyroid gland. Occasionally a carcinoma (cancer) is a very rare cause of hyperthyroidism we see. The most common finding is weight loss due to an increase rate of metabolism. Cats will tend to eat more (sometimes having a ravenous appetite). Weight loss can sometimes be quick or gradual. Other signs include anxiety, nervousness, increased heart rate, vomiting, diarrhea, increased thirst and urination, panting and sometimes a poor haircoat. Overtime if left untreated, hyperthyroidism can have effects on internal organs such as the liver, kidneys, and muscle. Hyperthyroidism is easy to diagnose by your veterinarian based on history, physical, and routine blood tests.

Q2. How is Hyperthyroidism Treated?

Hyperthroidism can be treated medically, surgically, feeding a life-long low iodine diet, or Radioactive Iodine. Medical treatment consists of administering a medication called methimazole once or two times daily. This medication helps control clinical signs but is not a cure. The drug blocks thyroid secretion but does not destroy or remove thyroid tumor. The thyroid will continue to grow while on methimazole. Many cats will develop large thyroid tumors and some will undergo malignant transformation into thyroid carcinomas (cancer). Feeding a low-iodine diet can work but does not destroy the thyroid tumor. The commercially available diet (Hill’s y/d) is sometimes not very palatable and is lower in protein which can sometimes be problematic for cats which require a higher protein diet. Surgery is a cure but can result in severe post operative complications such as hypocalcemia. Radioiodine (I-131) is a cure. This is simple, it is a safe, and is a single subcutaneous injection of Radioiodine (I-131).

Q3. Why is Radioiodine preferred instead of medicine or surgery?

Radioiodine-I-131 has a distinct advantage and is the treatment of choice for treating hyperthyroidism. There is no need for anesthesia and post operative risks from surgery are avoided. No medicine is needed and the only major downside is that your cat will stay in the hospital for a few days (usually 3-5 days). Overall I-131 is a simple, effective, and safe cure.

Q4. How does radioiodine work?

Normal thyroid function requires iodine. Iodine is part of our everyday diet and commonly added to salt. When iodine is ingested, the thyroid gland takes up the iodine. Here the iodine becomes incorporated into thyroid hormone. When your cat receives radioactive iodine, the tumor in the thyroid uptakes the radioactive iodine much like it does normal orally ingested iodine. All of the thyroid tumor will take up the radioactive iodine. Once all of the tumor uptakes to I-131, the radioiodine starts emitting radiation, destroying the overactive thyroid tumor cells. A hyperactive thyroid tumor, suppresses the function of any normal thyroid tissue. The normal thyroid cells will therefore not take up any radioactive iodine. This is very important meaning that cats rarely develop an underactive thyroid gland (hypothyroidism) after radioiodine therapy. After treatment, the normal thyroid tissue will regain full function within 1-3 months. The average cure rate using I-131 is 98% resulting in a safe, effective cure with one single injection.

Q5. Is my cat too old for radioiodine treatment?

Hyperthyroidism in cats can be treated at any age as long as there are no other life-threatening diseases present.

In order to make sure no other problems are seen, a number of screening tests may be done prior to treatment.

Making an appointment and preparing your cat for Radioiodine Treatment:

1. How do I make an appointment for this treatment?

Please ask your veterinarian to send us, by fax or email, a patient referral form (this will be highlighted and they can click on for the form), together with the results of your cat’s history, physical examination, serum T4 level and any routine bloodwork.

All of the routine blood tests must have been done within 1 month prior to treatment.

This routine bloodwork can be done while your cat is on (or off) methimazole.

Since hyperthyroid cats commonly develop secondary heart disease, a chest x-ray is required in all cats that were first diagnosed longer than 6 months.

If other abnormalities are present such as chronic diarrhea, vomiting, an abdominal ultrasound is strongly recommended to rule out other disease processes.

2. What should I do to prepare my cat at home in the week prior to treatment?

If your cat has been treated with methimazole (Tapazole, Felimazole) your cat needs to be off the drug for at least 7 days prior to treatment.

If you or your veterinarian feels your cat’s hyperthyroidism is too severe to discontinue medication, please have your veterinarian contact us to discuss other options.

Treatment Stay During Radioiodine Treatment:

1. How long is the hospital stay during treatment:

The length of stay can vary from cat to cat. We measure the amount of radioactivity emitted by your cat’s thyroid everyday to make sure the thyroid has adequate radioiodine to be effective. By measuring the amount of radioiodine emitted, this will let us know when your cat can be discharged. The length of stay varies from 3 to 5 days.

2. Can I check on my cat during their stay?

Our entire staff is committed to ensuring your cat has the best stay possible. Attention to detail is ensured. Please feel free to call us anytime to check on your furry feline.

3. Can I visit my cat during their stay?

Unfortunately, we can’t allow you to visit during the stay because of the potential for radiation exposure. We will be happy to send you a picture or video during their stay.

4. Are there any side effects or risks with radioiodine?

There are almost no side effects from radioiodine treatment. When your cat returns home, there may be a readjustment period while your cat’s thyroid returns to normal function. Your cat may be quieter and less active . This is due to the metabolic rate returning to normal. Your cat will regain the weight that was lost and his appetite will return to normal and not eat as much as before when he/she was hyperthyroid.

5. Should I bring anything for my cat?

Please feel free to bring any toys, food, etc. with your cat during their stay for radioiodine treatment. We discourage this because anything that is brought into the radioiodine treatment room must not leave and will not be sent home with your cat.

6. What happens when my cat is discharged from treatment?

When your cat’s radioactivity level is below the legal limit to send home, we will contact you to make an appointment for discharge. We will review with you what precautions that you should expect over the following two weeks.

Initial At-Home Care for your cat treated with Radioiodine.

1. What precautions should I take initially when my cat comes home?

Upon discharge, your cat will be minimally radioactive. The level of radioactivity is much lower that when human patients are discharged.

Please take the following precautions: a. You can play with your cat and cuddle but limit this time to about 20 minutes/day for 7 days. b. A safe distance for your cat throughout the day is at arm’s length c. Do not let your cat be on your bed while sleeping. d. Do not let your cat be near children or pregnant women.

2. What do I need to do with my cat’s litter?

Most of the radioactive material is excreted in the feces and urine. For the first 2 weeks we advise flushing your cat’s litter in the toilet (make sure you use flushable litter). We also advise wearing gloves during this time.

If flushing the litter is not possible, we advise storing the litter in a container for 3 months to allow the decay of radioactive litter. (If you have any questions about this please don’t hesistate to contact us).

3. These precautions seems like my cat is hazardous to me. How dangerous is the radiation?

The amount of radiation your cat may be emitting is very low. The amount of radiation you might receive from your cat is roughly equivalent to that received when you fly round-trip across the country.

Human patients receiving radioiodine therapy can receive up to 10 times the amount of radiation cats do and still go home the day they are treated. The majority of the radioiodine in urine and feces your cat excretes is while your cat is staying with us.

While these discharge instructions seem alarming, these are extremely cautious and conservative. If you follow our instructions, you and your family will receive almost no exposure at all.

4. How soon will my cat return to normal?

Your cat’s behavior will change within a few weeks. Some cats require 2-3 months for all the clinical signs to return to normal. Your cat will become calmer, gain weight, better grooming, vomiting will stop, and less drinking and less urinating.

5. Should my cat’s thyroid be tested after radioiodine treatment?

We recommend monitoring at 1 and 3 months after treatment.

We will test a T4 level at that time.

At 6 months we recommend that all cats have a complete thyroid profile (T4, T3, free T4, and TSH level)

At Riverbark, we have a full-service in-house pharmacy for all of your pet’s needs. There are three ways you can refill your pet’s prescription:

1. In-person—Stop in during regular business hours and request a refill 2. Phone—Call us during regular business hours to order refills 3. Online—Use the Pet Portal to order refills that will be delivered to your door

Welcome to River Bark Animal Hospital, we have two locations in Fayetteville and Spring Lake, NC. We have been providing cutting edge quality health care to pets in the Fayetteville area since 1975. We are known for being an exceptional veterinarian and having a very informative staff. We set the standards in our area for what a full-service veterinary hospital should be like. Our lead veterinarians, Dr. Jack Brown, Dr. Dale Brown, and Dr. Jenny Rodriguez and their staff are committed to providing only the highest quality veterinary care throughout the life of your pet. We will treat your animal family members as if they were our own.

We provide the area’s largest range of progressive veterinarian services to ensure only the highest quality of care for companions. A few of the services we offer include: Dental x-ray, Dentistry, In-House Laboratory, General Surgery, Pet Physical Therapy, Medical Concerns, Vaccinations, Spays and Neuters, Professional Grooming and Boarding. Our Spring Lake location also has a full-service pet resort.

Our mission at River Bark Animal Hospital is to provide you and your pet the best possible care, with only the highest level of service. As we continue to expand our website, you will find useful information about our pet health care team, provided services, and so much more. We have built our reputation one vet visit at a time. We believe that all of your furry family members and you deserve to have only the best up to date care.